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Resilient and responsive health systems in a changing world

Guest Editors: Siri Wiig and Jane O'Hara

About the collection

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The world is amidst one of its greatest public health challenges due to the tragic impact of the global COVID-19 pandemic. We have witnessed the extreme strains on health systems but also their resilience and responsiveness to the pressures they have faced. We must also recognize that it is not only COVID-19 that has put a strain on health systems. Other infectious diseases, economic pressures, environmental disasters, staff shortages, and chronic diseases are amongst the many other challenges health systems are facing. 

In support of the challenges that global health systems are facing and UN Sustainable Development Goal 3, Good Health and Well-being, BMC Health Services Research has launched a collection that welcomes submissions that contribute to our understanding of how health systems respond and resist the pressures they face, and how we can sustainably strengthen health systems for the future. 

For more information about the scope of the collection, please read our introductory commentary article written by our Guest Editors. 


Meet the Guest Editors

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Prof. Siri Wiig, University of Stavanger, Norway

Siri WiigSiri Wiig, PhD, MSc, is Professor and Centre Director at SHARE - Centre for Resilience in Healthcare, at the University of Stavanger (UiS), Norway. The SHARE centre is a large research group in Norway doing research on quality and safety in healthcare, with over 70 researchers affiliated. Wiig is a full Professor of Quality and Safety in Healthcare Systems at the Faculty of Health Sciences, UiS. Key research interests are resilience in healthcare, patient safety, quality improvement, safety investigations, user involvement, risk regulation, leadership, and learning in socio-technical systems.

Prof. Jane K. O'Hara, University of Leeds, UK

Jane O'HaraJane K. O'Hara is a Professor of Healthcare Quality & Safety, based at the University of Leeds, and Deputy Director of the Yorkshire Quality & Safety Research Group. Her research interests include resilient healthcare, exploring and operationalizing safety theories, safety measurement and management, and patient and family involvement in patient safety.

Submission guidelines

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This collection welcomes submissions of Research articles, including systematic reviews, quantitative, qualitative, and mixed-methods research on the topic of resilience and responsiveness in all areas of the health system. ReviewsStudy Protocols, and Comments will be considered at the discretion of the Journal’s Editor. Please note that unsolicited Reviews and Comments will not be considered, as per our submission guidelines. 

Articles will undergo the journal’s standard peer-review process overseen by our Guest Editors, Prof. Siri Wiig (University of Stavanger, Norway) and Prof. Jane O’Hara (University of Leeds, UK). Articles will be added to the Collection as they are published.

Before submitting your manuscript, please ensure you have carefully read the submission guidelines for BMC Health Services Research. Please ensure you highlight in your cover letter that you are submitting to a collection. Articles for this Collection should be submitted via our submission system, Snapp. During the submission process you will be asked whether you are submitting to a Collection, please select "Resilient and responsive health systems in a changing world" from the dropdown menu".

Please visit this page to find out more about our article-processing charges. Members of Health Systems Global can claim a 20% discount on our article-processing charges, more information can be found here.

Articles submitted after 31st January 2023 will not be eligible for inclusion in the collection.

Published collection articles

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  1. Resilience in healthcare is the capacity to adapt to challenges and changes to maintain high-quality care across system levels. While healthcare system stakeholders such as patients, informal carers, healthcar...

    Authors: Veslemøy Guise, Mary Chambers, Hilda Bø Lyng, Cecilie Haraldseid-Driftland, Lene Schibevaag, Birte Fagerdal, Heidi Dombestein, Eline Ree and Siri Wiig
    Citation: BMC Health Services Research 2024 24:230
  2. Health systems worldwide struggled to obtain sufficient personal protective equipment (PPE) and ventilators during the COVID-19 pandemic due to global supply chain disruptions. Our study’s aim was to create a ...

    Authors: Paula Götz, Willem L. Auping and Saba Hinrichs-Krapels
    Citation: BMC Health Services Research 2024 24:130
  3. Stock-outs of some life-saving drugs, such as emergency obstetric drugs, are evident in many health facilities and have been reported to be the leading cause of maternal mortality and morbidity for women from ...

    Authors: Jean Claude Kabera and Marie Françoise Mukanyangezi
    Citation: BMC Health Services Research 2024 24:14
  4. The studies of hospital resilience have been of increasing importance during the last decade due to disasters and pandemics. However, studies in developing the domain and indicators of hospital resilience were...

    Authors: Nurmala Sari, Maye Omar, Syahrir A. Pasinringi, Andi Zulkifli and Andi Indahwaty Sidin
    Citation: BMC Health Services Research 2023 23:1395
  5. Health care has the intrinsic obligation to preserve health. This concept is also applicable to planetary health. Nitrous oxide (N2O) lacks clinical indications in modern anaesthesia, while it is a high-potential...

    Authors: Ferdinand Lehmann, Christian M Schulz, Dominik Leicht, Scott Brady, Anna Fuhrmann, Jens Prütting, Max Georg Hügel, Daniel Hörr and Michael Sander
    Citation: BMC Health Services Research 2023 23:1392
  6. Prompted by recent shocks and stresses to health systems globally, various studies have emerged on health system resilience. Our aim is to describe how health system resilience is operationalised within empiri...

    Authors: Samantha Copeland, Saba Hinrichs-Krapels, Federica Fecondo, Esteban Ralon Santizo, Roland Bal and Tina Comes
    Citation: BMC Health Services Research 2023 23:1297
  7. In May 2021, the Irish public health service was the target of a cyber-attack. The response by the health service resulted in the widespread removal of access to ICT systems. While services including radiology...

    Authors: Gemma Moore, Zuneera Khurshid, Thérèse McDonnell, Lisa Rogers and Orla Healy
    Citation: BMC Health Services Research 2023 23:1112
  8. Responsive and resilient strategies to reduce high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of the highest maternal...

    Authors: Ashley Gresh, Anne Batchelder, Nancy Glass, Janet Mambulasa, Esnath Kapito, Amy MacDonald, Nellie Ngutwa, Cori Plesko, Ellen Chirwa and Crystal L. Patil
    Citation: BMC Health Services Research 2023 23:1098
  9. Vaccine hesitancy is recognized as a significant public health threats, characterized by delays, refusals, or reluctance to accept vaccinations despite their availability. This study, aimed to investigate the ...

    Authors: Mehrdad Askarian, AmirAli Rastegar Kazerooni, zahra Shayan, Parisa Karimzadeh, Mohammad Movahedi and Nahid Hatam
    Citation: BMC Health Services Research 2023 23:1051
  10. Central to Safety-II is promoting resilience of healthcare practices. In the “Room for Resilience” research project we focus on the role of horizontal and vertical accountability in healthcare teams and aim to...

    Authors: Jan-Willem Weenink, Jaco Tresfon, Iris van de Voort, Teyler van Muijden, Jaap Hamming and Roland Bal
    Citation: BMC Health Services Research 2023 23:1048
  11. When the COVID pandemic hit the world, there was need for applied guides and training materials to support frontline health care staff to manage patients effectively and safely and to educate themselves and co...

    Authors: Sophie Witter, Guanyang Zou, Kiran Cheedella, John Walley and Haja Wurie
    Citation: BMC Health Services Research 2023 23:1026
  12. For patients receiving daily opioid agonist treatment (OAT) for opioid dependence, several countries relaxed treatment guidelines at the beginning of the COVID-19 pandemic. This involved longer take-home inter...

    Authors: Rebecca McDonald, Anne Berit Bech and Thomas Clausen
    Citation: BMC Health Services Research 2023 23:965
  13. The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational ...

    Authors: Karen McKenna, Stéphane Bouchoucha, Bernice Redley and Anastasia Hutchinson
    Citation: BMC Health Services Research 2023 23:940
  14. Pandemics such as Corona are currently major health concerns worldwide. Health system responsiveness to the medical and non-medical needs of patients during pandemics is essential. This study aimed to examine ...

    Authors: Ehsan Teymori, Seyed Saeed Tabatabaee, Saeed Akhlaghi, Azam Delavarinejad and Fatemeh Kokabisaghi
    Citation: BMC Health Services Research 2023 23:909
  15. Historically, efforts to improved healthcare provisions have focussed on learning from and understanding what went wrong during adverse events. More recently, however, there has been a growing interest in seek...

    Authors: Cecilie Haraldseid-Driftland, Heidi Dombestein, Anh Hai Le, Stephen Billett and Siri Wiig
    Citation: BMC Health Services Research 2023 23:890
  16. Hospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- ...

    Authors: Ann-Therese Hedqvist, Gesa Praetorius and Mirjam Ekstedt
    Citation: BMC Health Services Research 2023 23:851
  17. Certain factors contribute to healthcare professionals’ adaptive capacities towards risks, challenges, and changes such as attitudes, stress, motivation, cognitive capacity, group norms, and teamwork. However,...

    Authors: Foteini Tsandila-Kalakou, Siri Wiig and Karina Aase
    Citation: BMC Health Services Research 2023 23:799
  18. Epidemics caused by emerging respiratory viruses are challenging for the health system of most societies, and preparedness of the health system in responding to such epidemics is important. Therefore, the aim ...

    Authors: Hojatolah Najafi, Zahra Kavosi, Mahnaz Rakhshan, Jalal Karimi, Milad Ahmadi Marzale, Mostafa Bijani and Mahmoudreza Peyravi
    Citation: BMC Health Services Research 2023 23:776
  19. Resilience, the capacity to adapt and respond to challenges and disturbances, is now considered fundamental to understanding how healthcare systems maintain required levels of performance across varying condit...

    Authors: Louise A Ellis, Yvonne Zurynski, Janet C Long, Robyn Clay-Williams, Eline Ree, Mitchell Sarkies, Kate Churruca, Fiona Shand, Chiara Pomare, Maree Saba, Cecilie Haraldseid-Driftland and Jeffrey Braithwaite
    Citation: BMC Health Services Research 2023 23:745
  20. The delivery of quality healthcare for women and children in conflict-affected settings remains a challenge that cannot be mitigated unless global health policymakers and implementers find an effective modalit...

    Authors: Faiza Rab, Donya Razavi, Mariam KONE, Salim Sohani, Mekdes Assefa, Muhammad Haaris Tiwana and Rodolfo Rossi
    Citation: BMC Health Services Research 2023 23:738
  21. COVID-19 caused disruption to healthcare services globally, resulting in high numbers of hospital admissions and with those discharged often requiring ongoing support. Within the UK, post-discharge services ty...

    Authors: Charlotte Overton, Tristan Emerson, Rachael A Evans and Natalie Armstrong
    Citation: BMC Health Services Research 2023 23:720
  22. The Symptom and Urgent Review Clinic was a service improvement initiative, which consisted of the implementation and evaluation of a nurse-led emergency department (ED) avoidance model of care. The clinic was ...

    Authors: Angela Mellerick, Georgina Akers, Niall Tebbutt, Tyler Lane, Rebecca Jarden and Kathryn Whitfield
    Citation: BMC Health Services Research 2023 23:710
  23. Response to COVID-19 pandemic in Bangladesh was led by the Government of Bangladesh aided by Non-Government Organisations (NGO) among others. The aim of the study was to explore the activities of such an NGO t...

    Authors: Tanvir Ahmed, Parsa Musarrat and Zarina Nahar Kabir
    Citation: BMC Health Services Research 2023 23:656
  24. Theories of learning are of clear importance to resilience in healthcare since the ability to successfully adapt and improve patient care is closely linked to the ability to understand what happens and why. Le...

    Authors: Cecilie Haraldseid-Driftland, Hilda Bø Lyng, Veslemøy Guise, Hilde Valen Waehle, Lene Schibevaag, Eline Ree, Birte Fagerdal, Ruth Baxter, Louise A. Ellis, Jeffrey Braithwaite and Siri Wiig
    Citation: BMC Health Services Research 2023 23:646
  25. Although slack is an asset to resilient hospitals, it is usually explicitly discussed only in terms of the quantity and quality of beds and staff. This paper expands this view by addressing slack in four infra...

    Authors: Carlos Emilio Stigler Marczyk, Tarcisio Abreu Saurin, Iamara Rossi Bulhões, Riccardo Patriarca and Federico Bilotta
    Citation: BMC Health Services Research 2023 23:579
  26. Sub-Saharan Africa is experiencing a dual burden of chronic human immunodeficiency virus and non-communicable diseases. A pragmatic parallel arm cluster randomised trial (INTE-AFRICA) scaled up ‘one-stop’ integra...

    Authors: Marie Claire Van Hout, Flavia Zalwango, Mathias Akugizibwe, Moreen Namulundu Chaka, Josephine Birungi, Joseph Okebe, Shabbar Jaffar, Max Bachmann and Jamie Murdoch
    Citation: BMC Health Services Research 2023 23:570
  27. The COVID-19 pandemic had a major impact on healthcare systems around the world, and lack of resources, lack of adequate preparedness and infection control equipment have been highlighted as common challenges....

    Authors: Camilla Seljemo, Siri Wiig, Olav Røise and Eline Ree
    Citation: BMC Health Services Research 2023 23:492
  28. Health systems aim to provide a range of services to meet the growing demand of Dubai's heathcare system aims to provide a range of services to meet the growing demand of its population health needs and to ens...

    Authors: Nahed Monsef, Eldaw Suliman, Elham Ashkar and Hamid Yahay Hussain
    Citation: BMC Health Services Research 2023 23:468
  29. The coronavirus pandemic has had a profound impact on organization and delivery of care. The challenges faced by healthcare organizations in dealing with the pandemic have intensified interest in the concept o...

    Authors: Agnieszka Ignatowicz, Carolyn Tarrant, Russell Mannion, Dena El-Sawy, Simon Conroy and Daniel Lasserson
    Citation: BMC Health Services Research 2023 23:376

    The Correction to this article has been published in BMC Health Services Research 2023 23:731

  30. As health systems struggle to tackle the spread of Covid-19, resilience becomes an especially relevant attribute and research topic. More than strength or preparedness, to perform resiliently to emerging shock...

    Authors: Paulo Victor Rodrigues de Carvalho, Hugo Bellas, Jaqueline Viana, Paula de Castro Nunes, Rodrigo Arcuri, Valéria da Silva Fonseca, Ana Paula Morgado Carneiro and Alessandro Jatobá
    Citation: BMC Health Services Research 2023 23:349
  31. Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people’s experiences with accessing these services. A scoping revi...

    Authors: Karen McBride-Henry, Solmaz Nazari Orakani, Gretchen Good, Michael Roguski and Tara N. Officer
    Citation: BMC Health Services Research 2023 23:346
  32. Workflow interruptions in pharmacies contribute to dispensing errors, a high-priority issue in patient safety, but have rarely been studied from a systemic perspective partly because of the limitations of the ...

    Authors: Takahiro Kojima, Noriyasu Kinoshita, Harumi Kitamura, Koji Tanaka, Ayumi Tokunaga, Satoshi Nakagawa, Takeru Abe and Kazue Nakajima
    Citation: BMC Health Services Research 2023 23:331
  33. Resilient healthcare organizations maintain critical functions and high-quality care under varying conditions. While previous research has focused on the activities of frontline healthcare professionals workin...

    Authors: Ingrid Svensson, Mia von Knorring, Heidi Hagerman, Cecilia Fagerström, Mirjam Ekstedt and Lisa Smeds Alenius
    Citation: BMC Health Services Research 2023 23:321
  34. COVID-19 has caused significant public health problems globally, with catastrophic impacts on health systems. This study explored the adaptations to health services in Liberia and Merseyside UK at the beginnin...

    Authors: Yussif Alhassan, Zeela Zaizay, Laura Dean, Rosalind McCollum, Victoria Watson, Karsor Kollie, Helen Piotrowski, Olivia Hastie, Colleen Parker, Russell Dacombe, Sally Theobald and Miriam Taegtmeyer
    Citation: BMC Health Services Research 2023 23:304
  35. Resilience is often referred to when assessing the ability of health systems to maintain their functions during unexpected events. Primary healthcare forms the basis for the health system and thus its resilien...

    Authors: Soila Karreinen, Henna Paananen, Laura Kihlström, Kristiina Janhonen, Moona Huhtakangas, Marjaana Viita-aho and Liina-Kaisa Tynkkynen
    Citation: BMC Health Services Research 2023 23:233
  36. Health care facilities are responsible for preventing and controlling diseases and must be resilient enough to deal with crises. The Iranian health care facilities have faced challenges in managing COVID-19 pa...

    Authors: Farahnaz Ezzati, Ali Mohammad Mosadeghrad and Ebrahim Jaafaripooyan
    Citation: BMC Health Services Research 2023 23:207
  37. In pandemics, it is critical to find a balance between healthcare demand, and capacity, taking into consideration the demands of the patients affected by the pandemic, as well as other patients (in elective or...

    Authors: Ritva Gisela Rosenbäck and Ann Svensson
    Citation: BMC Health Services Research 2023 23:202
  38. BRAC (Bangladesh Rural Advancement Committee), the largest NGO globally, implemented a community-based comprehensive social behavior communication intervention to increase community resilience through preventi...

    Authors: Fahmida Akter, Malika Tamim, Avijit Saha, Imran Ahmed Chowdhury, Omor Faruque, Animesh Talukder, Mohiuddin Ahsanul Kabir Chowdhury, Monzur Morshed Patwary, Albaab-Ur Rahman, Morseda Chowdhury and Malabika Sarker
    Citation: BMC Health Services Research 2022 22:1590

    The Correction to this article has been published in BMC Health Services Research 2023 23:60

  39. Discussions of health system resilience and emergency management often highlight the importance of coordination and partnership across government and with other stakeholders. However, both coordination and par...

    Authors: Kate Gooding, Maria Paola Bertone, Giulia Loffreda and Sophie Witter
    Citation: BMC Health Services Research 2022 22:1441
  40. Amidst ongoing calls for increased health systems resilience, gaps remain in our understanding of how health systems can reach further into communities to ensure resilient service delivery. Indeed, public heal...

    Authors: Victoria Haldane, Warren Dodd, Amy Kipp, Hannah Ferrolino, Kendall Wilson, Danilo Servano Jr., Lincoln L. Lau and Xiaolin Wei
    Citation: BMC Health Services Research 2022 22:1385
  41. The coronavirus disease 2019 (COVID-19) pandemic has had various impacts on businesses and workers worldwide. The spread of infection has been reported through cluster outbreaks in the workplace, and World Hea...

    Authors: Yu Igarashi, Seiichiro Tateishi, Tomoko Sawajima, Kodai Kikuchi, Mika Kawasumi, Juri Matsuoka, Arisa Harada and Koji Mori
    Citation: BMC Health Services Research 2022 22:1294
  42. Research on health systems resilience has focused primarily on the theoretical development of the concept and its dimensions. There is an identified knowledge gap in the research on how to build resilience in ...

    Authors: Lena Forsgren, Fabrizio Tediosi, Karl Blanchet and Dell D Saulnier
    Citation: BMC Health Services Research 2022 22:1173
  43. To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organizations worldwide need a high level of resilience, to adapt and respond to challenges and changes a...

    Authors: Cecilie Haraldseid-Driftland, Stephen Billett, Veslemøy Guise, Lene Schibevaag, Janne Gro Alsvik, Birte Fagerdal, Hilda Bø Lyng and Siri Wiig
    Citation: BMC Health Services Research 2022 22:1091
  44. Hospitals are the biggest users of the health system budgets. Policymakers are interested in improving hospital efficiency while maintaining their performance during the economic crisis. This study aims at ana...

    Authors: Zeynab Foroughi, Parvin Ebrahimi, Aidin Aryankhesal, Mohammadreza Maleki and Shahram Yazdani
    Citation: BMC Health Services Research 2022 22:977
  45. The prevailing patient safety strategies in suicide prevention are suicide risk assessments and retrospective reviews, with emphasis on minimising risk and preventing adverse events. Resilient healthcare focus...

    Authors: Siv Hilde Berg, Kristine Rørtveit, Fredrik A. Walby and Karina Aase
    Citation: BMC Health Services Research 2022 22:967
  46. Resilient healthcare research studies how healthcare systems and stakeholders adapt and cope with challenges and changes to enable high quality care. Team leaders are seen as central in coordinating clinical c...

    Authors: Birte Fagerdal, Hilda Bø Lyng, Veslemøy Guise, Janet E. Anderson, Petter Lave Thornam and Siri Wiig
    Citation: BMC Health Services Research 2022 22:908
  47. The COVID-19 pandemic severely exacerbated workplace stress for healthcare workers (HCWs) worldwide. The pandemic also magnified the need for mechanisms to support the psychological wellbeing of HCWs. This stu...

    Authors: Benjamin Rosen, Mary Preisman, Heather Read, Deanna Chaukos, Rebecca A. Greenberg, Lianne Jeffs, Robert Maunder and Lesley Wiesenfeld
    Citation: BMC Health Services Research 2022 22:780
  48. The COVID-19 pandemic has challenged healthcare organizations and puts focus on risk management in many ways. Both medical staff and leaders at various levels have been forced to find solutions to problems the...

    Authors: Maritha Jacobsson, Maria Härgestam, Fredrik Bååthe and Emma Hagqvist
    Citation: BMC Health Services Research 2022 22:738
  49. The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction.

    Authors: Faten Amer, Sahar Hammoud, Haitham Khatatbeh, Szimonetta Lohner, Imre Boncz and Dóra Endrei
    Citation: BMC Health Services Research 2022 22:621